"Telemedicine and Access to Care" will be one of the first national conferences to systematically examine the uses of sophisticated two-way video telecommunications for improving access to modern medical care in the U.S. The rapid development of technology in this field has brought it to a point where it has become a cost-effective way to deliver medical care, especially to rural underserved areas. The critical need for the U.S. to explore new ways for both improving the delivery of care to all people, and to decrease the cost, mandates that this technology be actively explored. This conference, October 1-3, 1993, will bring together a wide range of individuals from tertiary medical care facilities, rural health care, telecommunications technology, and health policy analysis. The goals of the conference will be to: 1. explore creative new ways in which telemedicine can be used to improve cost-effective delivery of health care in the U.S.; 2. introduce conferees to the variations in telemedicine technology and delivery paradigms in use today and probable configurations in the future. Emphasis will be placed on reliability as a medical care delivery system, acceptability to patients and health care providers, and cost comparisons of different systems - today and in the 21st century. As a integral part of "Telemedicine and Access to Care" a Consensus Conference format will be employed. This Consensus Conference will bring together working groups of people from divers backgrounds, with the goal of preparing consensus documents, reviewed and modified by the overall conference, on the following subjects: a. Telemedicine as a vehicle for improving delivery of health care to rural, underserved areas b. Identification of jurisdictional barriers which must be overcome to allow for maximum effective use of telemedicine c. Identification of models and research questions to investigate the cost-effectiveness of telemedicine Funding from the Agency for Health Care Policy and Research will enhance and support attendance of rural health care providers at this conference to expand their input into research on how to best use telemedicine to deliver health care to rural communities. Funding will also support the widest dissemination of the consensus documents prepared from this conference to stimulate discussion and inquiry into telemedicine as a vehicle for cost-effective delivery of medical care.